Introducing… a manager of community and population health services

Jana Cochrane is a manager in Hamilton Health Sciences’ (HHS) Community & Population Health Services program. She has been in this role since April 2018 and has been with HHS for 17 years, starting her career as an occupational therapist in acute medicine.

Most recently, she was a member of the HHS Outreach Team, a community-based group of health professionals that partners with patients and other providers to make it easier for patients to access health and social services.

What do you do?

The Outreach Team at HHS works with patients to optimize their health and well-being. We identify needs and develop coordinated care plans with health, community and social service partners.

We also focus on what matters most to the patient and what is most concerning to them about their health.

Our patients have multiple chronic health conditions. They tend to have no one in their lives to support them. They are not health literate, are cognitively and/or functionally impaired and frequently live in poverty.

We’re so proud of the work we do to improve the lives of some of Hamilton’s most marginalized residents.

What do you love most about your job?

I love helping others. The spirit of kindness is so prevalent at HHS.

We receive many donations from staff, such as compact fridges and microwaves that we pass on to our patients so they can store and cook food. The HHS Foundation is also generous with donations to help with urgent essential needs identified for our patients transitioning from hospital into community.

Addressing the social determinants impacting health has led to better quality of life and well-being for our patients while decreasing: ED visits; re-admissions; and length of stay when patients require an admission.

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